Provider Demographics
NPI:1093373706
Name:SANFORD, ROBIN DANIELLE (CF-SLP)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:DANIELLE
Last Name:SANFORD
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:DANIELLE
Other - Last Name:LANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3701 S ORCHARD ST APT I10
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98466-7912
Mailing Address - Country:US
Mailing Address - Phone:206-947-6193
Mailing Address - Fax:
Practice Address - Street 1:535 DOCK ST STE 104
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4629
Practice Address - Country:US
Practice Address - Phone:253-874-9300
Practice Address - Fax:206-374-2533
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI60875062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist